小儿急性细菌性痢疾菌群及药物敏感性动态变化研究

Study of Drug Sensitivity and Bacterial Clump of Children Acute Bacterial Disentary

目的了解小儿急性细菌性痢疾药物敏感性及菌群变化,指导临床合理用药。方法对9年来经细菌学证实小儿急性细菌性痢疾93例分3个阶段药物敏感性进行比较及菌群分析。结果9年来小儿急性细菌性痢疾病原菌以福氏志贺菌为主,菌群分布无变化,未发现新的菌群。志贺菌对头孢三嗪、头孢噻肟、头孢他啶、头孢哌酮舒巴坦、丁胺卡那霉素、左氧氟沙星保持很高的敏感性。对头孢哌酮敏感性2001-2003年度下降至85.7%,随后升至93.5%。对庆大霉素的敏感性逐渐上升。对氨苄青霉素、复方新诺明、诺氟沙星的敏感性一直很差。结论本地区小儿急性细菌性痢疾病原菌仍以福氏志贺菌为主,未发现新的菌群。治疗小儿急性细菌性痢疾比较安全有效的抗生素是三代头孢菌素,谨慎选用丁胺卡那霉素、左氧氟沙星。

Objective To investigate the change trend of drug - sensitivity and bacterial clump of children acute bacterial dysentery to guide clinical drug usage（ rational drug usage in clinical practice）. Methods The analysis/variance of bacterial and condition of drug - sensitivity among three different stage in 93 cases of children acute bacterial dysentery were compared with bacteriological identification in the nine years. Results Shigella flexeri was found to be predominant in children acute bacterial dysentery in the nine years. Bacterial clump distribution did not change and new bacterial clump was found. Shigella was high sensitive to Cefriaxone, Cefotaxime, Cefotazidime, Cefoperazone and Sulbactam, and Amikacin, and Levofloxacin. The sensitivity to Cefoperazone descended to 85.7% in 2001 -2003 years and increased to 93.5% in later years. The sensitivity to Amicillin sodium, SMZco and Norfloxcin was consistently lower than others. Conclusion Shigella flexeri continues to be the predominant bacterial clump in children acute bacterial dysentery in the area and new bacterial clump is not found. Third generation cephalosporin is more effective and safe to cure children acute bacterial dysentery. Take cautions about using Amikacin and Levofloxacin.